Peridis S, Moonim M T, Roberts D, Al-Sarraj S, Hopkins C
Department of Otolaryngology Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK.
J Laryngol Otol. 2011 Jul;125(7):753-6. doi: 10.1017/S002221511100048X. Epub 2011 Mar 30.
To present a case of a child with a desmoplastic fibroma of the vidian canal, compressing the vidian nerve.
A 12-year-old girl with several years' history of right-sided facial pain was referred to our institution. Magnetic resonance imaging and computed tomography scans showed an expansile mass involving the right vidian canal. The patient underwent a complete endoscopic surgical resection aided by the FusionTM ENT navigation system. This was performed through a transnasal, trans-septal, trans-sphenoidal route via the right nostril, and achieved macroscopic clearance with minimal peri-operative morbidity. A biopsy of the lesion showed a fibro-osseous lesion consistent with desmoplastic fibroma.
Diagnosis and resection of this rare lesion at an earlier stage would have avoided delays in resolving the child's disabling pain. This emphasises the importance of early referral of unusual cases to tertiary centres.
报告一例患有翼管促结缔组织增生性纤维瘤并压迫翼管神经的儿童病例。
一名有多年右侧面部疼痛病史的12岁女孩被转诊至我院。磁共振成像和计算机断层扫描显示右侧翼管有一膨胀性肿块。患者在FusionTM耳鼻喉导航系统辅助下接受了完整的内镜手术切除。手术经右侧鼻孔通过经鼻、经鼻中隔、经蝶窦入路进行,实现了肉眼下完全切除,围手术期发病率极低。病变活检显示为符合促结缔组织增生性纤维瘤的纤维骨性病变。
早期诊断并切除这种罕见病变本可避免延误解决患儿的致残性疼痛。这强调了将不寻常病例尽早转诊至三级中心的重要性。